Nursing Judgment Reflection

Nursing Judgment Reflection

The healthcare landscape is a dynamic field, bringing together an amalgam of healthcare professionals. A point of convergence in healthcare is the determination of these professionals to provide the best care to their patients. Integral to this resolve is the ability of each professional cadre to execute their roles diligently and maintain accountability in patient care. Nurses remain the cornerstone of healthcare operationalizations. Their roles position them to directly engage with their patients and other caregivers toward optimizing clinical outcomes. This paper reflects on nursing roles in the healthcare landscape, emphasizing how they make clinical judgments, how they use nurses’ processes, the significance of using critical principles in infection control, and concepts of physical assessment of key body systems.

Judgement in Nursing Clinical Practice

Judgment-making remains a component of clinical processes. Clinical judgment involves making informed choices from competing options in real-time patient care processes by applying critical thinking and clinical evidence (Watkins, 2020). It stretches beyond simple recognition and elucidation of patients’ presenting complaints and disease manifestations to making keen considerations of appropriate therapeutic choices, potential outcomes, and compatibility of the available therapeutic options with the patients.

Making clinical judgments that are supported by evidence and integrating nursing science in the provision of safe, quality care can be challenging to nurses at all levels of practice. This is probably due to the uniqueness of patient presentations and the dynamicity of the healthcare landscape (Jessee, 2021). Clinical judgment models such as Tanner’s model of clinical judgment alleviate this dilemma by providing a framework utilizable by nurses to make informed clinical decisions. This model helps nurses structure their thought processes, thereby helping them make accurate assessments and nursing interventions.

The first component of clinical decision-making, per Tanner’s model postulates, is noticing. This step involves maintaining attentiveness, being observant of the clinical environment, and presenting complaints (Manik & Callaway, 2023). This step implores nurses to develop keen awareness and engage their senses when doing clinical assessments. This includes being attentive to the body language, verbal and non-verbal cues, and alterations to the patient’s behavior that may signal illness. This will help me as a nurse to recognize patterns and identify patient features suggestive of disease.

The second step is interpretation. This step involves critical evaluation of the obtained data and consideration of its significance in patient health. This process borrows heavily from the nurses’ knowledge of factors interplaying in disease and suffering. It requires me as a nurse to utilize the best available knowledge base and evidence on disease processes (Manik & Callaway, 2023). The next step is developing a response. This process involves elucidating all possible options from a range of possibilities and evaluating their appropriateness based on their effectiveness. As a nurse, in this respect, I’m expected to determine evidence-based approaches that are most effective and compatible with the patients. Effective responses often require a collaborative approach, drawing other caregivers. The final step is reflection. It involves a critical analysis of the selected options to evaluate their effectiveness in addressing the presenting complaint (Manik & Callaway, 2023). It also involves identifying areas for improvement and alternative therapeutic choices.

Nursing Process

Nursing processes provide a systematic guide to clinical decision-making. This patient-centered approach details an intervention-oriented and patient-tailored approach to determining the presenting illnesses and how to address them. The five nursing processes are assessment, diagnosis, planning, implementation, and evaluation.

Nursing processes provide a framework for organizing, analyzing, and responding to varying patient needs (Yilak et al., 2022). They tailor nursing operationalizations towards excellent patient care by ensuring that nurses demonstrate critical thinking, problem-solving skills, and creativity. The implications of nursing processes are often evident in patient-centered care aligned with the therapeutic plan for the patient, time efficiency, better clinical communications, and enhanced quality of care.

Patient-centered care involves engaging patients in their treatment processes and serving them with dignity. Nursing processes help in optimizing a patient-centered approach to nursing care by guiding nurses towards using scientific and holistic postulates in the caring processes. Additionally, nursing processes exploit the fundamental nursing and clinical problem-solving skills, intuitions, and critical thinking that will guide nurses toward providing nursing care that dignifies their patients. This explains why these processes are important in patient care. Nursing processes also foster time-efficient nursing care. By providing a systematic way of providing effective nursing care, nurses can take shorter yet effective time managing their patients. This contributes to the overall cost-effectiveness of nursing care and explains the need to utilize these processes.

Nursing processes also contribute to enhanced quality of care. By providing a systematic way of executing nursing roles, nursing processes provide a better guarantee of accuracy in clinical decision-making and elucidation of presenting illnesses. This helps in reducing mismanagement and quality compromises during nursing care. It further reinforces the need to employ nursing processes during routine nursing care.

Overall, nursing processes provide a systematic guide to nursing care processes. It is a critical tool nurses have at their disposal and ingrained in their practice. Other than providing an efficient way of utilizing nursing knowledge in real-time clinical problem solving, it tailors nursing processes towards patient-centeredness. It is for these reasons that nurses should use these processes to organize, analyze, and respond to patient needs.

Importance of Identify Critical Principles in the Maintenance of Infection Control and Safety

Infection control is one of the major nursing functionalities. It provides a better guarantee of safety at individual and community levels. The critical principles in the maintenance of infection control and safety include but are not limited to hand hygiene, respiratory and cough hygiene, personal protective equipment, risk assessment and patient placement, and safe management of the care environment (Dewi et al., 2023). Nurses’ position in healthcare makes them the champions of patient safety and infection control. Their roles can either make them the catalysts for infection spread or a reason for sustained maintenance of infection control. It is thus necessary that they identify critical principles in the maintenance of infection control and Safety.

Identifying the principles of infection control and safety will help nurses curtail the spread of common infections. The principles of hand hygiene, respiratory and cough hygiene, and safe management of the care environment are integral to the control of common respiratory and diarrheal infections (Dewi et al., 2023). Maintaining hand hygiene through handwashing with soap and running water is known to eliminate common GI and respiratory pathogens. Likewise, personal protective equipment such as face masks breaks infection transmission chains, thereby helping in infection control and safety.

Identifying the principles of infection control and safety also helps ensure better health for other caregivers and patients. The principle of risk assessment details nursing responsibilities towards injury prevention. By identifying the risk potential for various patient groups, nurses can implement preventive measures for these groups. The principle of a safe care environment and infection control strategies such as hand hygiene, personal protective equipment, and respiratory hygiene are also helpful in reducing infection spread between caregivers.

Nurses, being patient educators and health advocates, maintain the duty of educating patients on the critical principles of infection control. These include the need for regular hand washing with soap and running water, the need to wear a face mask when in specific settings, and the need to maintain a safe environment (Dewi et al., 2023). As health advocates, they play a role in voicing safety concerns to the appropriate authorities for positive change to occur. It is thus important that nurses maintain knowledge of these principles for a better guarantee of infection control and the safety of themselves and others.

Why Nurses need to be able to Discuss Concepts of Physical Assessment

Nursing assessment is a core component of the nursing process and involves collecting data on the patient. Integral to the comprehensive nursing assessments is physical assessment. It is the process of evaluating anatomic findings likely to suggest the presence of an illness in the patient. It utilizes observations, auscultations, percussions, and palpation in its attempt to identify abnormalities in the anatomic features that give insight into any underlying pathology. Physical examination findings can be integrated with the subjective data to come up with a diagnosis.

Physical assessments usually follow through systems. Comprehensive physical examinations assess major body systems such as the integumentary, cardiovascular, gastrointestinal, respiratory, and neurological systems. Maintaining knowledge of these systems, as well as how they function and appear, is thus key in the comprehensive assessment of patients as it helps in informing disease diagnosis. Nurses, therefore, must know these systems and how they vary across the human developmental lifespan.

Discussing concepts of physical assessment helps nurses elucidate anatomical changes due to disease and those attributed to normal human developmental processes. In the human development process, anatomical and physiological alterations become apparent. The transition from childhood through to adulthood is usually characterized by changes at organ and tissue levels that have a predilection on how organ systems will appear and function (Fontenot et al., 2022). Consequently, in the integumentary system, skin tends to become thinner and more fragile as an individual ages. During assessment, it is thus important for nurses to elucidate changes attributable to normal human developmental processes and those due to disease processes.

Discussing physical assessment concepts also enhances nurses’ efficiency when handling various groups of patients. Variations in the anatomical features of human across the lifespan may sometimes impact their handling requirements. As individuals age, functionality declines due to senile atrophy becomes apparent. While this has a trajectory on what they can or cannot do, it also affects care processes (Fontenot et al., 2022). For instance, changes in the anatomy of the musculoskeletal systems may present the patient with fragility and weakness. This may put them at risk of fall injuries. Such patients have a higher nursing care acuity and may sometimes warrant preventive care.

The space of nurses in contemporary healthcare warrants nursing excellence. In their pursuit to excel and subsequently optimize clinical outcomes, they are obligated to maintain knowledge of key aspects of nursing operationalizations. As evident above, nursing processes are important guides to effective nursing. Understanding critical principles of infection control and safety, the significance of concepts of physical assessment, and the prerequisite clinical judgment skills will reinforce their positions in healthcare.

 References

Dewi, L., Hamid, A. Y., & Sekarsari, R. (2023). Experiences of infection prevention and Control Nurses (IPCNs) in performing their roles and duties in the Indonesia Army Central Hospital: A qualitative descriptive study. Belitung Nursing Journal, 9(2), 145–151. https://doi.org/10.33546/bnj.2482 

Fontenot, N. M., Hamlin, S. K., Hooker, S. J., Vazquez, T., & Chen, H. (2022). Physical Assessment Competencies for Nurses: A Quality Improvement Initiative. Nursing Forum, 57(4), 710–716. https://doi.org/10.1111/nuf.12725

Jessee, M. A. (2021). An update on clinical judgment in nursing and implications for education, practice, and regulation. Journal of Nursing Regulation, 12(3), 50–60. https://doi.org/10.1016/s2155-8256(21)00116-2 

Manik, M. J., & Callaway, P. (2023). The implementation of Tanner’s clinical judgment model and the Indonesian version of the Lasater clinical judgment rubric in the clinical setting. Applied Nursing Research, 73, 151725. https://doi.org/10.1016/j.apnr.2023.151725

Watkins, S. (2020). Effective decision-making: Applying the theories to nursing practice. British Journal of Nursing, 29(2), 98–101. https://doi.org/10.12968/bjon.2020.29.2.98

Yilak, G., Getie, A., Fitwi, A., Wondmieneh, A., & Gebremeskel, T. (2022). Implementation of nursing process and its associated factor among nurses at Woldia Comprehensive Specialized Hospital, Northern Ethiopia: An institution-based cross-sectional study. Nursing: Research and Reviews, Volume 12, 111–119. https://doi.org/10.2147/nrr.s368097

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How will you as a nurse make judgments in practice, supported by evidence, that integrate nursing science in the provision of safe, quality care? (300 word minimum)
Discuss why the nurse uses the nursing process as a method to organize, analyze, and respond to a variety of patient needs. (300 word minimum)
Why is it important for the nurse to be able to identify critical principles in the maintenance of infection control and safety? (300-word minimum)
Why is it important for the nurse to be able to discuss concepts of physical assessment of key body systems (integumentary, respiratory, cardiovascular, abdominal, and neurological) across the lifespan? (300 word minimum)
Complete your reflection in APA format, Size 12 Times New Roman font, with a cover page and reference page. A minimum of one reference is required. Please submit 1200-1500 words on what it means to you to use nursing judgment as a nursing student.